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Tell Panic Attacks to Go Suck It

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If you frequent this site I’m going to guess that at one time or another you may have enjoyed the crippling embrace of a panic attack. How could I predict such a thing??? Because people who suffer from anxiety tend to be smarty-pants-creative types, aka NERDISTS. Folks not blessed with the gift of hyper-self-awareness don’t really understand the rush of liquid fear that floods the body. They just think we’re being “kooky.” I have a joke in my act about trying to describe the feeling of a full-blown panic attack: “Imagine being F*CKED in the HEART.”

I had my very first panic attack at about age 10. Adorable! For some reason or other I thought I had eaten rat poison and was convinced that the flush I felt running through me was, in fact, poison-related. Fortunately I’m here to say that it was not poison, or at least INCREDIBLY slow-acting poison (maybe I should call my doctor). After that episode I didn’t get them again until college. Unaware of the concept of a panic attack, I was convinced that something was horribly wrong with me and I couldn’t leave my apartment for a month. The prospect of having it happen in public kept me under emotional house-arrest. It wasn’t until a friend of mine pointed out, “Oh yeah, that’s a thing. Lots of people have those.” The sheer knowledge that I wasn’t a freak helped ebb the panic tide for a while but every now and again I’d still get the hilariously familiar, “No…wait…THIS time it’s something fatal.” I’m here to tell you that not only are panic attacks NOT fatal, but I don’t get them anymore. THAT CAN ABSOLUTELY HAPPEN FOR YOU. In this article I’d like to share a few tips that I’ve learned over the years while navigating the anxiety steeplechase.KEEP YOUR HEARTRATE DOWN
This could be the single most important thing to remember. It’s easy to believe that panic is purely emotional, but it’s not. It’s physiological. Emotions may set it off, but once the trigger has been pulled it’s “100% pure adrenaline!” as Point Break would say. (It would also say, “Ayeee am an FBI AyyyGENT!!!” and then we would hold Point Break while rocking and patting it and saying, “Shhhhh…of course you are….”) What your body is ACTUALLY plunging into is survival mode, or the classic Fight or Flight response. This explains is why you want to punch the air or run yourself into a wall like a 28 Days Later chimp. This impulse is left over from our forest dwelling days and is usually reserved for actual life or death situations. Think of it as an evolutionary gift that keeps on giving. And giving.

I’m not purporting to have a complete grasp of neuroscience, but if I were to take a guess I would say that our brain isn’t some wonder-organ that all of the sudden just appeared from the Ether and existed in harmonious wholeness (sorry, Creation Museum). It is the result of millions of years of more and more complex layers lumping over our lizard stems like a bad spackle job. When you feel that first twinge of panic your body is asking itself, “Am I in danger?” and for panic sufferers the answer is usually, “WHY, IN FACT I AM!!!” even though they’re not really—the brain is just misfiring, bless it. It means well. It’s just trying to protect us REAL HARD. The body then takes us down the adrenaline river ride that we all know and love, shedding our higher brain functions along the way until we end up a heap of panting flesh not knowing which way to run, reduced to LOLcat syntax as our means of communication: “Me wan tare skin noff!” It’s a survival mechanism with abject terror as a delightful side-effect.

Let’s examine that first point of entry, “Am I in danger?” Sometimes it might be enough to gently say, “No,” or at least acknowledge, “OK, I know what this is…” But if that don’t cut the cerebral mustard try to remind yourself how adrenaline gets through your body: though a fast-pumping heart. That is why it is CRUCIAL to keep your heart rate down. If your heart is slow and normal, you cannot experience anxiety. It is impossible to exist in both states. Remember, this is a chemical thing. Rather than focusing on how “You might really be dying this time,” focus on the SCIENCE of what’s happening to you. Your instinct may be to fight, but that just makes it worse. Focus on actually making your heart beat SLOWER. Pretend it’s a game and first prize is sanity.

AVOID CAFFEINE
As you probably know, panic & caffeine have an electrical sexual chemistry: the former comes right after the latter (terrible pun mostly not intended). About eight years ago my attacks flared up again after having been dormant for some time. “WHY IS THIS HAPPENING AGAIN???!” I pondered over a nice hot cup of coffee one day about five minutes before another one hit. When I went over the timetable of events in my head, there seemed to be a connection. Just for the hell of it, I Googled “coffee & panic attacks” and proceeded to enjoy the two million pages that popped up, warning of the atomic dangers of caffeine to the panic-stricken. I know, coffee is a bitchin’ dominatrix that kicks your ass through the day with a 20 oz. boot, but at what cost? If you can let it go, you should. You will experience almost instant results. Like not thinking you’re dying.

BREATHE, MAN, BREATHE!
Just think, if you had a panic attack 500 years ago they’d have thought you were possessed by some manner of dark spirit and you’d’ve had the panic burned or bled out of you! Stupid Middle Ages! Today, we know that simple yet proper breathing techniques are helpful with no loss of blood necessary. At the onset of an attack it will feel counter-intuitive but you have to trust that it works. Take slow breaths, in through the nose, out through the mouth and let the oxygen fill your lungs as you push your tummy out (yes, I am a grown man who uses ‘tummy.’ I find it more palatable than ‘food bag’ or ‘shit garage’.) This process will help you in two ways: 1) A slowed heart can’t pump fear through your body, and 2) The very act of focusing on a measured activity will take your thoughts away from your panic.

Most people breathe very shallowly, up in their chest, and this is very true of panicky-types. Especially when you feel that chest tighten. When you take a good, productive breath your stomach should extend outward because you’re getting air all the way into your lungs. When you exhale, your stomach will go back in, pushing the air out. If you can sit quietly for a few minutes while doing this, you will start to feel your chest relax and warm, tingly bits in the pit of your tummy. Imagine those are spreading though your body. You will feel all keen. Remember, you need oxygen to live so get that stuff into you. Take a yoga class…learn to meditate…buy some new age-y book on breathing…play a sitar…whatever it takes. It’s worth it because you’re worth it.

EPILOGUE

Welp, I hope you’ve gained some insight today and that, if you are a panic sufferer, you know that you have hope, which sometimes by itself is enough to make the panic dragons stop dining on your soul. But keeping that heart rate below “NASCAR” isn’t just for panic attacks anymore! It’s also good for quelling anger, hysteria and just plain old stress (the vanilla of neuroses). Why share my failures and deeply personal experiences with you? Because I want you to feel better. No one should have to live in fear of oneself ESPECIALLY when the threat isn’t real. Don’t let your body trick you. It is possible to ignore your brain. It’s a process but you can do it. If you forget any of this stuff in the middle of the night, you can always bookmark this page and come back to it because the Internet is FOREVER. Now please get out of my head!!!

*As a tribute to the theme of this post, I’m including at no additional charge this classic Hard ‘n Phirm video that is an en fuego Latin love song celebrating the ubiquitous nature of the word that pops up in every Spanish song: El Corazón—THE HEART.

143 comments

thank you, dr. hardwick. i experienced my first panic attack a few months ago, haha, and it was HORRIFYING! i’ve spent a lot of time since then trying to break it down and make sure that horrible episode never happened again. thanks for the insight!!

Some words of advice: Don’t, and I repeat DON’T, EVER take Tylenol PM and accidentally not fall asleep! MAJOR panic/self awareness ATTACK!!! I did that once because I was not feeling well so I took one, and then decided to read myself to sleep. Unfortunately, for me, the book was interesting so I ended up reading for 3 hours and forgot about the Tylenol PM. Long story short, it was like being on acid, minus the fun.

After many years of panic attacks I have found my salvation. Klonopin. 0.25mg when they get really bad. I have learned when the ones that get out of control I can take this, curl up, or focus on something totally mundane (i.e. yahoo games) for about 15 minutes. By that time, I have my med kick in and I am a happy happy camper. BTW…0.25mg is the smallest possible therapeutic dose there is. My fear of becoming addicted to it has kept me from abusing it ofr 5 years now.

For two years of my life (2002-2004, roughly) I had daily panic attacks (3-10 a day) that seemed to come out of nowhere, and turned me into a zombie, afraid to have an emotion or do anything strenuous in case it set one off. My index finger is still caloused from the constant unconscious chewing I used to do in order to get through them, and my shoulders are permanently damaged from living around my ears all that time.

It took 3 doctors testing and telling me, “there’s nothing wrong with you” before I found one that actually diagnosed the panic attacks, which cut down on the severity and frequency. And he introduced me to sweet lady Ativan.

Eventually, I was able to figure out that the attacks were related to food, and then, specifically, gluten. After a positive Celiac disease blood-test, and going gluten-free, I haven’t had a serious attack since. But those two years were pretty much a write-off.

“you want to punch the air or run yourself into a wall like a 28 Days Later chimp.” sums it up very well, as does the urge to tear one’s own skin off.

Panic-attacks run in my family. We’re a bunch of engineers, artists, musicians, actors, librarians. Several of my close family have agoraphobia, a terrible life-limiting condition. I’m a musician/photographer and practioner of using technology well in business and I can tell you that I’m so glad more and more people are recognizing panic attacks don’t mean we’ve got a weak-constitution… WIMPS. With panic attacks, the very act of THINKING about them, trying to rid ourselves of them, during an attack makes them worse. It’s like our ultimate friend–our mind–suddenly turns on us.

Love your article. Great tips. My attacks went from a crippeling 15-20 per day to a few times a year as I’ve been using the types of tips you’re speaking of, as well as a mild medication. Funny thing is, I love people, love being in social settings, especially in front of a crowd. And most of my attacks happened when I wasn’t the center of attention… Very strange. Anyway, thanks, man!

I suffer from anxiety and have endured some really bad panic attacks – the kind that make you end up in the ER at 3am. Thanks for putting a positive spin on things. Next time I am convinced I’m dying, heart pumping like Statham in Crank 2, I’ll try to remember that it’s because I am a creative genius ….like Hardwick.

In the video what does it mean “it goes to the lungs to be purified” or something like that? Is it the blood goes into the lungs? Gasp! That would mean blood would fill the lungs. But I’m here to say that oxygen enters the lungs then is transported into the heart through the pulmonary veins thereby oxygenating the blood in the heart to be pumped to the other parts of the body. Nothing is being purified. Sorry I’m a biology major. Kind of a geek, too. LOL

Another really effective breathing technique is to reverse the normal process; put all your effort in to expelling as much air as possible on the out breath, then relax and let physics do its thang by filling the vacuum you just created.

My latest panic attack involved me tasting blood all night and being convinced I was bleeding to death internally. The funny part is, they generally happen in the middle of the night, and I can only assume my brain thinks it’s hilarious to ambush me when I’m totally out of it and unable to be rational about what I’m experiencing.

Thanks for the article. I’ve been suffering from panic attacks for a while and have been searching for ideas to help cope. My mother has been having them for years and I guess it was just a matter of time before I got them. Thanks for the tips!

my last panic attack happened when i was torn between protecting my family or leaving to california. in my hysteria i panic texted my friend to see if we had a future, good thing my mom got the phone when she called. I’m not in Cali but still far enough to do my own thing, i live in New Mexico btw. Although i learned to control my panic sometimes it just sneaks up on me but i learned to control through hysteria with minor body aches from the adrenaline rush. and i have panic attacks in my dreams that actually happen i find those more fun cuz i don’t remember having them with major proof, I’M ALIVE!!!!!!!!!!!!!!!!!!!

Caffeine and I parted ways this past holiday season. Caffeine was making me freak out over the mass snow we got up here in Seattle. She’s a sassy bitch when she dosn’t get her way, but I was honest with Caffeine, reminded her she has lovers all the planet who need her help to quell migraines. She took it well, though my friend in Boston is pissed at me! Sheesh!

Wow, thanks for this article. I’ve always considered myself so cheerful and sane, but recently have gone through some serious anxiety. Not sure if panic attack but certainly something alike. Your pieces of advice struck me: I totally need to implement them all. Thanks again and cheers from buenos aires.

I’ve had panic attacks for over 40 years, and I’ve never had them explained so succinctly or accurately. Of course, there is the kind one gets from fibromyalgia where your brain falls out and THEN you panic, but the somatic symptoms are the same, so the result and cure are similar. Thanks for a funny, empathetic, and useful post on a problem that shames and confounds more of us that the average population — whatever that may be — and thanks to Wil Wheaton for leading me here.

I must reiterate the kudos of others. For me a panic attack is USUALLY based on a real world stress situation like being lost at night in the rain. But lately I’ve been experiencing late night panics . . and mostly I have handled them using some of the techniques you’ve mentioned. Your advice is right on! I might even try to dial back the caffeine consumption, but I use caffeine to self medicate for depression so it’s a balance.

I also have taken the smallest dose of Klonopin and find that it takes enough of the edge off for me to get through. Since I quit caffeine, (God how I suffered more for quitting than for the attacks) I’ve been relatively more ‘normal’ and can certainly cope much better. In fact, I haven’t taken meds in ages…so there is hope, ya’all!

I was convinced that something was horribly wrong with me and I couldn’t leave my apartment for a month. The prospect of having it happen in public kept me under emotional house-arrest.
Even after knowing that it’s “just” a panic attack, and that hundreds of people out there suffer through the same thing, I’m still under emotional house arrest. I haven’t been able to leave my house unless I’m within touching distance of a friend for over a year.

KateMcSweeney : I have insomnia. *ANY* sleep med will do that to me, unless it’s strong enough to knock me out for 20 hours straight. Good to know I’m not the only one who goes psycho over those damn things.

Yep! I gets ‘em too. Real bad from sometime last winter to about a month ago, I would constantly worry that if I went out to eat somewhere I would get sick, so I wouldn’t go out to eat. I flew to L.A. in May and worried the whole time that I would get airsick, even though I don’t get airsick. I even went to get a crap-load of tests at my doctors office, until I realized that I most likely have NOTHING at all wrong with me. This happened back after high school for a few months where I would be afraid to go to sleep because of the same things.

You have no idea how much I can relate to this. I can feel myself becoming agoraphobic because I am afraid to trigger an attack or have one in public.
Everytime I read something about someone else having them I feel a little bit better.

Good to know, good to know.
I used to get panic attacks where I would cry and shake and scream and scare the other little Girl Scout children because I thought that being by myself and not having air conditioning would make me horribly ill.
I’ve found that chewing gum helps a lot.
It takes my mind off of freaking out.

Wow! How did you know?
My nervousness has been awful lately, once in a while it gets like that. So looked up panic attacks and described the attacks to a tee, which kind of scared me more than it just being hormones.
(coughs) and since I am a creative type – can’t stop the thoughts that progress.
Thanks for the article! It comes right in time!

I wish I’d read something like this when I started having regular panic attacks at the age of 16. Like you, I had no idea what was happening; I was worried that I was going crazy and would have to be institutionalized.

Know what sucks? Having a nice Xanax prescription to help you if you get panic attacks, and then being unable to take them because the panic makes you deathly afraid of taking one and having a bad drug reaction or something (I’ve had a few bad experiences along that line before). To date, I’ve had the prescription for over a year and have never taken one. And the batch I have now is a refill of the first prescription because the last bottle expired without me taking one of them.)

That being said, I’ve gotten to the point where I can mentally stand back from my physiological panic responses and mercilessly mock the screaming monkey meat for it’s insistence that OMG WE’RE ALL GOING TO DIE!!!!!!!!! Unfortunately, it does little to slow my heart rate. My body refuses to trust my brain that, really, there’s nothing in the bedroom to be afraid of. *sigh*

Have you tried Valerian root? It’s not a sedative, so it doesn’t have those weird psychedelic tendencies. It’s a nervine, which means it calms your nerves but doesn’t “drug you” to sleep. It will, however, put you on your ass if you take enough, so test your dosage carefully. Also, it smells like a week-old gym bag, just so you know – yeah, it’s supposed to smell like that.